CPT 28150 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 11 - Office • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 59 - Distinct Procedural Service • T5 - Right foot, great toe |
| Complexity Level | Moderate |
National average reimbursement for CPT 28150 by major payers:
$538.69
$559.48
$560.45
$694.55
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 28150 | ||||||
United | 28150 | $774.00 | 1407247208 - COLONOSCOPY AND ENDOSCOPY CENTER LLC | 471628673 - (OH) COLONOSCOPY AND ENDOSCOPY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28150 | $600.00 | 1023507183 - SOUTH PERRY ENDOSCOPY PLLC | 462792041 - (WA) SOUTH PERRY ENDOSCOPY PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28150 | $1883.00 | 1922438472 - PARK AMBULATORY SURGERY CENTER, LLC | 463665760 - (TX) PARK AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28150 | $1380.00 | 1801220983 - THE MINIMALLY INVASIVE SPINE SURGERY CENTER OF PARADISE VALLEY, LLC | 461416301 - (AZ) THE MINIMALLY INVASIVE SPINE SURGERY CENTER OF PARADISE VALLEY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28150 | $1283.00 | 1609996149 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28150 | $5464.00 | 1619995180 - MED CITY DALLAS OUTPATIENT SURGERY CENTER, L.P., MEDICAL CITY SURGERY CENTER/DALLAS | 201043104 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28150 | $1200.00 | 1427307578 - HEMLOCK AMBULATORY SURGERY CENTER | 455511791 - (GA) HEMLOCK AMBULATORY SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28150 | $2353.00 | 1295060069 - TIMONIUM SURGERY CENTER, LLC | 270399689 - (MD) TIMONIUM SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28150 | $2017.00 | 1427116367 - BROOK PLAZA AMBULATORY SURGICAL CENTER, INC. | 112877356 - (NY) BROOK PLAZA AMBULATORY SURGICAL CENTER, INC. | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28150 | $819.50 | 1427326677 - ENCINITAS ENDOSCOPY CENTER, LLC, THE ENDOSCOPY CENTER | 453608354 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28150 | $1199.00 | 1457683914 - ATHENS EYE SURGERY CENTER,LLC | 271467225 - (GA) ATHENS EYE SURGERY CENTERLLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28150 | $2206.00 | 1407275282 - SURGCENTER CAMELBACK LLC | 464169482 - (AZ) SURGCENTER CAMELBACK LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28150 | $1203.00 | 1437706140 - GEISINGER-HM JOINT VENTURE, LLC | 831871064 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28150 | $4141.00 | 1386983260 - TEXAS HEALTH CRAIG RANCH SURGERY CENTER LLC | 383897811 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28150 | $8705.00 | 1306163431 - ROC SURGERY LLC, RILEY OUTPATIENT SURGERY CENTER | 271497960 - (IN) ROC SURGERY LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 28150 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28150 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 28150 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 28114-CPT | High | Ostectomy, Complete Excision; All Metatarsal Heads, With Partial Proximal Phalangectomy, Excluding First Metatarsal (Eg, Clayton Type Procedure) |
| 28124-CPT | Moderate | Partial Excision (Craterization, Saucerization, Sequestrectomy, Or Diaphysectomy) Bone (Eg, Osteomyelitis Or Bossing); Phalanx Of Toe |
| 28126-CPT | Moderate | Condylectomy,Phalangeal Base,Single Toe, |
| 28150-CPT | Moderate | Phalangectomy, Single, Each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28150. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28150 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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